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Immigrants and refugees are less likely to meet diabetes management goals than the general US population. Those with limited English proficiency (LEP) and who need interpreter services (IS) for health care encounters, maybe at higher risk for encountering barriers to optimal diabetes management, and while most receive diabetes care in primary care settings, little is known about the association between IS need and diabetes outcomes. This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013. Diabetes outcome measure goals were defined as hemoglobin A1C <8%, LDL-C <100 mg/dL, and blood pressure <140/90 mmHg. Process measure goals were defined as hemoglobin A1C measured within the previous 6 months and LDL cholesterol (LDL-C) measured within the previous 12 months. Compared to non-IS patients (N = 11,970), IS patients (N = 1486) were more likely to meet guideline outcome recommendations for blood pressure (Adjusted odds ratio [OR] 2.02; 95% confidence interval [CI] 1.70, 2.40), hemoglobin A1C (OR 1.23; 95% CI 1.08, 1.40), and LDL-C (OR 1.40; 95% CI 1.2, 1.62). Older IS patients and male IS patients were less likely to meet recommendations for hemoglobin A1C (OR 0.70; 95% CI 0.48, 1.02; OR 0.66; CI 0.54, 0.79; respectively) and LDL-C (OR 0.81; 95% CI 0.55, 1.17; OR 0.47; CI 0.39, 0.57; respectively). Healthcare system solutions need to bridge gaps from process to outcomes among LEP patients who require IS in primary care settings. [ABSTRACT FROM AUTHOR]

Our study examined the relationship between food and alcohol access by neighborhood socioeconomic status (SES) in a large urban county in Minnesota (n=298 census tracts). We hypothesized that the number of food stores would be negatively associated with the number of liquor stores in each census tract, and that the negative relationship between food and alcohol access would be stronger in poorer neighborhoods. Poisson regression was used to estimate effects. We found that the relationship between food and alcohol access differed by neighborhood SES, with higher income neighborhoods having more supermarkets and grocery stores and liquor stores (RR=1.47; p<.0001). Results suggest that food and alcohol access are interconnected and should be treated as related rather than distinct public health issues. [ABSTRACT FROM AUTHOR]